International sex and age differences in physical function and disability

Worldwide population aging will undoubtedly be accompanied by an increase in the number of disabled older adults. Female gender and increased age are two of the most widely identified risk factors for poor physical functioning and disability. Yet the contexts in which people are aging vary markedly across countries. Countries differ greatly in their level of economic development, both past and present. Economic development is in turn related to improvements in infrastructure, health care, public health, education, etc. that are hypothesized to be related to improved physical function and less disability. Therefore, this dissertation examined whether sex and age differences/changes in both objectively-measured physical performance and reported difficulties with functional tasks and activities of daily living (ADLs) were similar or varied across seven countries whose per capita GNP ranged from $200 to $40,100 (United Sates, Taiwan, Korea, Mexico, China, Indonesia, and the Tsimane of Bolivia). It also sought to determine if sex differences and age differences varied systematically in terms of macro-level indicators including GDP, life expectancy, and measures of gender equality. Overall, sex differences were remarkably consistent across countries with very different contexts. Sex differences in physical performance and functional limitations were more pronounced than sex differences in difficulty with basic self-care tasks, but the magnitude of differences did not vary systematically in relation to country-level measures of development or gender equality. This may be because gender equality can be either protective or detrimental, depending on the domain. In terms of age differences, it was necessary to consider both the level of performance/prevalence of difficulty at younger ages as well as age differences, since poor performance/high levels of difficulty among the young-old indicate that "aging" has already occurred. Some populations did appear to be "aging" more rapidly, particularly those at the lowest end of the development spectrum, however, there was no clear evidence for a linear correlation between macro-level indicators of development and age differences. Interestingly, findings showed that functioning in some domains could be fairly well maintained despite declines in other domains, and these varied across countries. For example, Indonesians appeared to be "aging" more rapidly in terms of upper body strength, but showed relatively high levels of lower body function and less age-related decline. This may be due to differences across populations in patterns of work, physical activity, the built environment, etc.

Copyright - Copyright ProQuest, UMI Dissertations Publishing 2014 Last updated - 2014-11-27 First page - n/a

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